Category Archives: Seborrheic Dermatitis

Natural Treatments for Dandruff

Dandruff on Head
Dandruff on Head.

A majority of people who have hair loss also seem to suffer from dandruff and scalp itching problems. Some get these outbreaks intermittently, while others have a daily battle on their hands. One survey found that 100-300 hairs were shed daily in dandruff sufferers, versus 50-100 hairs per day in normal subjects.

Previously, I wrote a detailed post on the best dandruff shampoos in the world. I myself have to use such shampoos twice a week in order to control my scalp itching, inflammation and flaking. Scalps with dandruff tend to have large amounts of Malassezia yeasts and flora, which can be reduced by antifungal medicated shampoos.

Natural and Alternative Dandruff Treatments

Tea Tree Oil Natural Treatment for Dandruff.
Tea Tree Oil Natural Dandruff Treatment.

However, there also exist alternative non-chemical natural treatments for dandruff that many claim to be very effective. Most such remedies are not scientifically proven to provide long-term relief for itchy scalps. Make sure to talk to a dermatologist for best advice.

Almost all of the below are natural products. All of them are readily available at grocery stores or pharmacies without the need for a prescription.

Per my online research, the most frequently mentioned alternative dandruff reducing products are:

  • Apple Cider Vinegar (ACV) or just plain old vinegar. ACV is considered by many to be a miracle treatment for numerous medical and dermatological problems. Some people dilute a teaspoon of apple cider vinegar in water and drink the concoction every single day. To combat dandruff, apply a small quantity of ACV to your scalp while showering. It can be used in combination with a shampoo or conditioner.
  • Tea Tree Oil. This product is recommended for numerous applications because of its antifungal properties. Tea tree oil contains terpinen-4-ol, which possesses significant anti-microbial properties. It also used to kill demodex mites. Other oils such as emu, eucalyptus, olive and peppermint are also said to help reduce scalp dead skin turnover.
  • Baking Soda. Besides fighting fungus, baking soda powder also absorbs excess oil on the scalp. It can cause a mild burning sensation.
  • Listerine or other mouthwashes with antiseptic properties. The alcohol in listerine can kill off Malessezia Globosa. However, frequent use of such a product can inflame and irritate your scalp skin. Other side effects include an overly itchy and dry scalp.
  • Aspirin. Crush the pills and leave on the scalp for 15 minutes or more, and then wash and rinse. Dirty work, but effective according to a number of online testimonials. Note that aspirin contains acetylsalicylic acid, similar to salicylic acid. The latter is found in many anti-dandruff shampoos.
  • Aloe Vera Gel. Yet another widely cited natural remedy for numerous dermatological afflictions. The healing aloe plant contains antioxidants and soothes the scalp.
  • Lemon Juice. Said to work by temporarily altering scalp Ph levels, which can destroy the Malassezia microbe.

What other natural products have readers tried to tackle their dandruff (seborrheic dermatitis)?

Note that in some cases, you might be suffering from psoriasis  or eczema rather than dandruff. Sometimes, psoriasis and sebborheic dermatitis are indistinguishable from each other and referred to as “sebopsoriasis”. Recent research has concluded that sebaceous glands are atrophied in both these skin conditions

Diets that are heavy in oil and fat can sometimes cause issues such as excess sebum and an itchy scalp.

Allergies to certain foods can also exacerbate scalp inflammation and itching. And finally, stress can worsen mild cases of flakes and dandruff.

Spironolactone for Hair Loss

Spironolactone and Hair Loss
Spironolactone for hair loss.

On this blog, I have often discussed the only two (Finasteride and Minoxidil) FDA approved drugs to treat hair loss. Finasteride is an oral drug that inhibits the enzyme 5α-reductase, which in effect then reduces the harmful-to-hair dihydrotestosterone (DHT).

Minoxidil is an antihypertensive medication that also happens to benefit scalp hair when used topically. This post covers a hair growth medication called Spironolactone (brand names Aldactone or Carospir).

Update: March 9, 2023 — A systemic review of the efficacy and safety of oral and topical Spironolactone in the treatment of androgenetic alopecia.


When it comes to hair loss medications, one area that I have neglected is anti-androgens such as Spironolactone, which have many favorable reviews. I did discuss RU-58841 in one post at the start of this year. However, there are numerous other anti-androgens out there, such as Fluridil and Flutamide.

In general, the potential side effects from anti-androgens are more severe than from Finasteride and Minoxidil. Moreover, scalp hair regrowth is typically more significant with Finasteride and Dutasteride.

Note that while some strict definitions consider Finasteride to also be an anti-androgen due to its inhibition of DHT, I only consider drugs that inhibit the binding of testosterone to androgen receptors as being anti-androgens. Finasteride, while reducing DHT, actually raises testosterone levels by around 10 percent. Also worth noting is that the popular Nizoral shampoo might have some anti-androgenic properties per several recent studies.

In this post I will discuss the most popular “true” anti-androgen in the world: Spironolactone.

Spironolactone for Hair Loss

Spironolactone (generally sold under the brand name Aldactone) is also referred to as “Spiro” and is a synthetic drug available via prescription. It belongs to a class of drugs known as potassium-sparing diuretics, and is used primarily as a diuretic and antihypertensive in the treatment of heart failure and hypertension.

However, secondary anti-androgenic applications have become more prevalent in recent decades. Spironolactone can stop hair loss, reduce body hair (hirsutism), reduce acne, help women with polycystic ovary syndrome (PCOS) and improve seborrheic dermatitis.

In 2020, a study found topical Spironolactone 1% gel and Minoxidil 5% gel to be an effective combination treatment for hair loss. An older study from 1998 concluded that topical Spironolactone inhibits dihydrotestosterone receptors in human sebaceous glands

Spironolactone Side Effects

While this drug may seem like a miracle product that can kill many birds with one stone, potential side effects are significant and plentiful. For men, feminization is a real danger when taking Spironolatone, meaning that you can developed gynecomastia (larger breasts) and see your testicles shrink. Men can also develop premature ejaculation and become infertile (although in most cases it seems like this side effect is not permanent) when taking this drug.

Less traumatic side effects include drowsiness, dry skin, excess urination, headache, nausea and vomiting. Spiro can potentially even lead to death from severe allergic reactions, hyperkalemia, kidney failure and more, although I have not read about this happening to any hair loss forum members. In general, the doses that hair loss patients take tend to be on the lower side.

You can learn a lot more about Spiro and its use to treat hair loss by tracking patients that take this product and post about it in the various online hair loss forums. I have never tried to take Spironolactone since I am very cautious when it comes to taking any kind of drug.

Mechanism of Action

Aldactone (Spironolactone) is a specific pharmacologic antagonist of aldosterone. It primarily acts through competitive binding of receptors at the aldosterone dependent sodium-potassium exchange site. Aldactone causes an increase in sodium and water excretion rates, while potassium is retained. The drug therefore acts as both a diuretic as well as an antihypertensive via this dual mechanism.

Spironolatone for Male-To-Female Transsexuals

I first learnt about Spironolactone when I read testimonials and forum posts from numerous male-to-female (MTF) transsexuals out of my own curiosity many year ago. It seems like estrogen and Spiro are the two main drugs that MTF transsexuals are almost always given.

Moreover, transsexuals often have to take a much higher dosage (100-200 mg per day to start, and considerably higher doses if ineffective) of Spiro compared to men or women who are only tackling balding. It is therefore important for you to visit transsexual/transgender forums on the internet and ask questions if you ever intend to take Spiro.